Reablement is an approach used within the aged care sector that provides short-term, at-home care for older people who have experienced a change in their ability to look after themselves.
Often, but not always, it is a service offered after someone has recently been discharged from hospital. It focuses on preparing the person to live independently again after their recovery, rather than becoming accustomed to relying on other people.
Reablement services may involve helping the person perform daily activities such as washing, cooking and cleaning, and then gradually enabling the person to perform the tasks by themselves.
What is Reablement in Aged Care?
Reablement is a temporary intervention that aims to help an older person adapt to their daily life after a serious injury or illness. Reablement provides support that is tailored to help the person regain their confidence and independence.
This approach is designed to promote wellbeing throughout recovery and reduce the amount of time spent in hospital.
Reablement is goal-oriented and will often address a specific barrier to independence, such as reduced functionality after surgery. Reablement is usually offered for up to six weeks, but the person may continue to receive other types of aged care once this period is over.
Reablement can also be described as a process to help someone ‘get back on their feet’. It is a program to enable someone to do things for themselves, through a relatively intensive, short-term support approach.
Despite the short timeframe, significant improvement can be achieved when reablement is correctly facilitated.
Who is Reablement Suitable For?
Reablement can be offered in a variety of situations, but is often targeted towards those who are most likely to benefit from it. This might include an older person with an acquired disability or someone who is recovering from an accident, such as a serious fall. Reablement may also be used for someone with a learning disability or who is recovering from an illness.
A reablement approach can be used for someone with dementia, but in many cases it may not be suitable. For older people who need ongoing support or who have health conditions that are unlikely to improve, reablement might not be an appropriate care plan.
What are the Benefits of Reablement in Aged Care?
The reablement program aims to adjust an older person to life at home, with the ultimate goal usually being complete independence. This reduces the demand for hospital beds and improves the quality of life for the older person. Other benefits include:
Customised to Client Strengths and Weaknesses
The short-term nature of reablement means that each individual program must take into account client strengths and weaknesses in order to be effective. The carer will consider what the client is already able to do by themselves so that they can focus on helping them achieve the tasks that might require more assistance.
Focuses on Specific Outcomes
At the beginning of the reablement period, the carer and client will discuss what the client wants to achieve by the end of the process. The ultimate goal of reablement is to help older people achieve full autonomy, but in some cases this might not be possible. Some clients may still need the help of family, friends or other aged care services in order to maintain improvement, but they should have an understanding of what they want to be able to do on their own.
Increasing an older person’s independence improves their self-esteem and confidence and enables them to enjoy life on their own terms. This freedom promotes wellbeing and expands the range of activities that they’re able to engage in. Even if the person still needs to receive aged care, quality of life can be improved by increasing their ability to perform simple tasks without help.
Reduces the Need for Future Care
Enabling people to be as independent as possible, especially those who are at risk of needing a greater level of care, will naturally reduce the pressure on care services. This also reduces the pressure on family and friends to take care of the person. If the person is able to adequately look after themself for longer, this may also decrease the likelihood that they will need to be admitted to hospital in the near future or that there will be ongoing support required.
Who is on a Reablement Team?
In order to be effective, a reablement approach requires a competent team of people. Usually, this team will consist of reablement assessors, occupational therapists and reablement support workers. It’s important for each team member to have an understanding of the key principles of reablement.
The reablement assessor will perform the task of assessing the client’s abilities. This will involve measuring their capabilities in a range of daily tasks. The reablement assessor may be an occupational therapist.
Occupational therapists may contribute to the service delivery by performing the reablement assessment, or they may act as advisers to other members of the team. Occupational therapists might also assist in training reablement workers.
Reablement Support Workers
Reablement support workers are the aged care staff members who will actively assist the older person during the reablement process. These workers will need to have received additional training to follow the support plan for the reablement approach.
An Example of Reablement in Aged Care
Reablement may include injury recovery techniques such as physical therapy as well as a wider range of activities to support independent living.
Physical rehabilitation might include balance exercises, weight training or motion training depending on the type of injury or the physical capabilities of the client.
Other reablement treatments might include:
- Accompanying the person on public transport until they feel comfortable going by themselves
- Strategising simple ways to make domestic tasks more manageable
- Helping the person use assistive equipment such as a laundry trolley or shower chair
- Skills training for ordering groceries and preparing meals
Effective Reablement Strategies in Aged Care
One of the key principles of reablement is the creation of a realistic support plan that is based on an assessment of the client’s abilities. The client will need to identify what the most important activities are for them to be able to do by themselves. These activities are likely to include:
- Daily living tasks such as showering, getting dressed and preparing meals
- Managing the household, including doing laundry, doing the washing up and vacuuming
- Engaging in movement or physical activity – this could range from moving safely around the house to going for a bike ride around the neighbourhood, depending on the physical function of the client
- Travelling to and from appointments or social activities
The person’s progress will need to be regularly assessed through observation to help the carer formulate clear steps for achieving the goal. Very small improvements may seem insignificant but will often be necessary in order to achieve the outcomes listed. For example, if the older person is not able to go to the toilet by themselves by a certain time, the carer may recommend that a toilet frame be installed.
Some other examples of reablement strategies include:
- Recommending that the older person perform tasks that they find difficult or draining in the morning, when they have the most energy.
- Performing stationary activities such as chopping vegetables or ironing clothes sitting down, at an appropriate height.
- Suggesting alternative ways of getting adequate levels of exercise. For example, if the person has trouble weight bearing, swimming may be an option.
Reablement is a program that aims to increase the independence of older people who may be at risk of becoming reliant on care. This is an important strategy because it will help to provide significant benefits to the mental wellbeing and quality of life of older people and relieve some of the need for ongoing support.
At Banfields Aged Care, we provide quality care and support for older people who wish to remain in a familiar environment. Facilitating independence is an important feature of the aged care services we provide, for all aged care residents.